What’s the safest medication

[Countrydweller2]

I am afraid of the medications available, they cause so much damage to the liver, kidneys and stomach, but doesn’t prevent a stroke. Does anyone depend on herbal remedies?

[BobD Volunteer]

Not very sensible if you are talking about anticoagulants as so called "natural " products are not quantifiable . There was a case last year of a gentleman who had been concocting his own and who died from uncontrolled internal bleeding.

When you say doesn't prevent stroke this is highly missleading. AF makes us five times more likely to have a stroke but anticoagulants reduce the chances by around 70%. As for the damage caused by them, well I've been on warfarin since 2004 with absolutely zero issues.

[Countrydweller2 in reply to BobD]

Thank you for your reply. I have heard warfarin is the best option, and a few of my friends have been on that for many years

[Hidden in reply to Countrydweller2]

I'm not qualified to say if Warfarin is the best option. I have been on it for nearly 13 years, trouble free. I was put on it when all the NOAC's were just developmental stuff. I self test and occasionally adjust my own doses, and with minor exceptions I am in the INR range 2.4 to 2.7 ... no sweat. I've also had to have medical procedures necessitating my stopping Warfarin for a while ..... no sweat. For me it is the anticoagulant of choice. It is my friend.

[Countrydweller2 in reply to Hidden]

Thank you!

[2learn in reply to Countrydweller2]

Hi, personal experience only so everyone differs. I was on warfarin for 9 yrs and had no probs. I liked the reassurance of having my INR checked and when stable this was about every 6-8 wks. INR nurses would help in any anti coagulant prep for hospital procedures and make sure you hit the recommeded targets, so less chance of turning up for an op to be told your INR was wrong and procedure cancelled. They would even do checks at home if you were incapacitated. Also I used to be able to have a drink with friends, I kept under 10 units a wk and there didn't seem any probs.

All that changed after I had a heart op last Dec. I was put on apixaban. There is no monitoring or reassurance any probs you have to go to A&E which in itself is is problem, you could bleed to death before you were seen. One of side effects is joint pain and I now find my arthritis is far, far worse since going on apixaban. Its not clear to me why its so recommeded. I have not been able to find any research comparing it with warfarin and outcomes. Its easier for NHS as they can redeploy or sack lots of INR staff and we do not know what kickbacks the NHS/docs get from switching more patients to apixaban. Medics I encountered will not engage in why apixaban re warfarin, the only answer is its better. I'm always suspicious if someone cannot argue their case. And additional downer you are not supposed to drink at all with apixaban, so bugger having a glass with friends, for celebrations, etc . Plus, plus, this year I had a stroke and a TIA, so how effective was apixaban, in 9 yrs of warfarin, no strokes.

[Countrydweller2 in reply to 2learn]

That is scary, a stroke and a tia on Apixapan, a drug with no guarantees. In fact it is known to damage the stomach, and they all damage the liver and kidneys. Are you still taking it?

[2learn in reply to Countrydweller2]

yes, I've argued with Docs about it and going back on warfarin but they say its better to stay on it. Currently I find if you disagree with someone in NHS it means they will no longer see you.

[secondtry]

Yes I sympathise with your concerns. This forum is testament to the difficulty over when and for how long you should take anticoagulants and then which one. I am borderline as whether to start taking ACs or not and have postponed the start based on the individual state of my body, my active lifestyle, CHADS score 1, cardiologist acceptance and my interpretation of the limited data out there. I do still take diet supplements which although almost certainly not equivalent to ACs should help a tad without side effects eg fresh garlic & Krill oil, more water. Others have mentioned Nattokinaise but I need to do more homework on that one. I also have annual blood/platelet tests but not sure how efficient that early warning system is.

Despite the inconvenience over testing etc warfarin with its longest safe track record and, I believe I am right in saying, derivation from clover on balance would have my vote as the safest. No doubt future studies on the NOACs funded by Big Pharma will show a different story.

[Countrydweller2 in reply to secondtry]

I have tried every natural thing I could find out about except Nattokinaise, I'm allergic to soya so this time I'm on xarelto despite the dangers and one of our doctors actually saying we can still have a stroke. I swear by raw garlic for sore throats and hawthorn made up by a medical herbalist for a bout of afib. Both work. I thought warfarin was rat poison.

[Singwell]

Many of us here are on a more modern anticoagulant under the brand name Apixiban. Never had any issues with it. Many meds might have an impact on the liver and kidneys and digestion. They key thing is to ameliorate this with plenty of hydration and a good lifestyle - healthy eating, low alcohol intake etc.

[CDreamer]

What makes you think herbal treatments are safe?

There is no ‘safe’ medicine. In my reasoning one has to consider the benefits and the risks and then come to a decision. Decisions are always based on which you fear most. I feared stroke, not of dying from stroke but of surviving. I feared Warfarin because of the increased bleed risk, therefor when I was offered DOAC I chose that, simply because the risk of damage to kidney in liver seemed less with the then novel anticoagulants than Warfarin.

I’ve not changed my mind and very happy on Apixaban and am monitored regularly for kidney and liver function.

[Countrydweller2 in reply to CDreamer]

Thank you! I have just come off apixaban because I was so ill on it and now have xarelto, but scared of all of them. How often are you monitored and what can be done for damaged liver, kidneys and stomach?

[Desanthony in reply to Countrydweller2]

I have been on apixaban for 6 years now with no problems I have full bloods checked every year or every 6 months - cardiologist says annually but my GP surgery want to do every 6 months so every 6 months it is. Never had any indication from the blood tests that anything is wrong - just had them done a couple of weeks ago and had an appointment with my GP this morning to go through them and take BP weight and BMI and all good.

[Ppiman]

I can only guess that you have been reading the information on side effects and have allowed it to skew reality. For most people, most of the time, the drugs given to treat AF are quite safe. Anti-arrhythmic drugs are less so, it is true, but, again, have a long and good safety record in general.

The internet has become an ally of alternative practitioners and herbalists and between them we now have a frightening mass of misinformation and pseudo-science, very much of it deceptively there to sell the modern snake-oil equivalents that are peddled and which are making people very rich indeed. But there we are, modern life where we all like to gainsay the real experts who stick to the scientific method and proper clinical studies. Caveat emptor, eh?

Steve

[Countrydweller2 in reply to Ppiman]

Thank you for replying. I am scared by the fact that there is a lot of profit in anticoagulants despite many court cases proving they have very serious side effects.

[Ppiman in reply to Countrydweller2]

The US is a litigious society where lawyers earn more than most ordinary folk could ever dream of. The UK is getting similar.

I don’t like taking anticoagulants since they do affect future health choices. The need for an operation is made far more complicated by taking them and stopping them for the op is not without added risks. But the fear of a stroke led me to put my trust in the cardiologist who prescribed them. That and my elderly friend, now nearly 90 and happy with his warfarin despite more than a couple of bad falls.

I suspect that anxiety can have many long term consequences, too. I sometimes envy those able to go through life in a more carefree way but we are what we are.

Steve

[Hidden in reply to Ppiman]

Hiya Steve,

Taking anticoagulants is neither here nor there for me .......... just don't care. A stroke certainly does terrify me.

On the topic of surgery .............. well I've been on Warfarin since January 2010, aged 65. Now aged 78. No sweat. In that time (since 2010) I've had CT scan, 2 x cataract surgeries, cortisone injection into right shoulder and a knee replacement ......... a walk in the park, even the knee replacement. Having surgeries while on anticoagulants just isn't the issue peeps believe it is ......... so long as peeps are honest and up front with whatever discipline is carrying out the medical procedure/surgery.

Further ... I understand from anecdotal evidence that a stroke arising from an AF event is usually more fatal than strokes from other sources.

John

[Ppiman in reply to Hidden]

That was really good to read, John - thanks for posting. I’m not expecting to need surgery but who knows with things like prostate and things.

Steve

[Countrydweller2 in reply to Ppiman]

On the contrary, our local medical herbalist does not push his own freshly made up remedies. He will tell us what his herbs are used for but makes no promises, unlike the 'real experts' who refrain from mentioning the court cases going on over injuries caused, or the many strokes still being suffered while taking these drugs. They tell us these drugs are purely for our benefit not the bank accounts of the gigantic profiteers.

[Ppiman in reply to Countrydweller2]

You are lucky to have such a sympathetic and kindly person, I would say. That counts for a very great deal these days. Generalising is never a good thing but I was referring to the fraudulent claims made on the internet for snake oils and the like. Facebook is full to bursting with such nonsense - ads that would never be allowed on any properly controlled media platform.

I sense that your view of those with genuine scientific expertise ("they...") has been skewed by some unfortunate experience, perhaps, since my view is quite the opposite; indeed, I am in awe at the constant drive to find safer and more effective medicines and treatments at universities such as our own Oxford and Cambridge research establishments.

Steve

[Silvasava]

Anti coag in one form or another or a stroke? My stroke was caused by undiagnosed Afib, luckily I was thrombolised in time and have no lasting effects. Next time I might not be so lucky so I will keep taking my Edoxaban. No issues and I've had 3 extractions over the last few years and no problem with bleeding then.

[Countrydweller2 in reply to Silvasava]

Thank you! Edoxaban has not been suggested. I'llcheck it out.

[Desanthony in reply to Silvasava]

Same here. Lots of complicated and long dental work - carried out and more to come in early Decemnber where they all decided there was no need to come off Eliquis (Apixaban) - no problems with bleeding and a total knee replacement and no problems - though a shame I couldn't take anti inflammatories post op.

[Ppiman in reply to Desanthony]

Good to read.

Steve

[Auriculaire]

My understanding of the reason we need to have tests for liver and kidney problems when taking DOAC anticoagulants is not because these drugs cause damage to the liver and kidneys but that because if the function of the liver and kidneys was to drop for other reasons the drugs would be cleared less efficiently . This would lead to a build up and could cause bleeding problems. The best way to find out if any particular drug is causing bad side effects is to stop it and see if the side effects stop , then to restart it to see if they come back . This is called rechallenge and is used in pharmacovgilance. If you have afib then you are more at risk of stroke and depending on your CHADSVASC score you need to find an anticoagulant that does not make you feel ill and then stop worrying about possible bleeds in the future that might never happen.

[Ppiman in reply to Auriculaire]

That was useful and interesting. Thanks.

Steve

[JOY2THEWORLD49]

hi

As a Stroke victim due to Thyroid Cancer which caused AF. The AF caused the stroke.

Relatively mild the statement that AF caused strokes are the worst are the worst is not correct. I awoke at 2am with a splitting headache and after trodding to the toilet went back to sleep until 5.30am.

I told St Johns and was umbulanced first to the next village where the helicoter used the beachfront to helicopter me to the big Northland Whangarei Hospital down the north island.

It was wet and windy! The outsider asked for something for sickness.

We stopped at BOI Airport for refuel.

They did not give me anything. I was not making sense in my speech and that was the most frightening thing. The homephone and not the cell identified where i was! Once I heard Joy I stopped crying.

The staff decided it was a back of head clot but CT showed it was a left frontal lobe clot.

Result, speech affected which returned slowly and I sang in the early Dec Christmas Choir as a soprano! right mouth drop which slowly changed back, swallowing, and right fingers swollen and stiff. Still cant knit but getting there.

Determination is key.

3 years later swallowing defect still there and hand.

I had no meds prior except for Solgar 1 x B12 week.

A carotid arteries' scan 4th day later showed Thyroid Cancer.

Early 5 months after stroke a throidectomy and 12 lymph nodes removed. I had chosen PRADAXA and it was 110mg x twice prescribed. The referred hospital changed it to 150mg x twice and I changed it back to 110mg as soon as I found the change.

2 x yearly scan checks and all clear.

I got no print out of thyroidectomy nor the thyroxin the synthetic drug of replacement hormone which replaces your natural process that the thyroid carries out.

I thought I could take an alternative natural herb or something.

I set off in reading. I even asked the chemist.

The synthetic thyroxin has been given since I think 1940s.

Folks do try the pigs thyroid alternative but our Pharmac and Medsafe say that pigs' thyroid concentration are all different and no two concentrations would be the same.

As the chemist and the literature told me no alternative I have accepted this information. There is a group of doctors in BOI that alternative meds can be got.

I rang them and as my research informed me I told them that I was no longer interested in their project on my plight.

It has taken me 2 years to finally get a frequent reading level of TSH 2.0 which was my reading before I had thyroid cancer. That done I can try 3-mthly blood tests in TSH.

So that is my story on alterative meds, And I did change from a cheap version to Synthroid which is reliable, has a kiddy lock lid, a date of expiry and a absorbent capsule within.

That task is over.

Research, research and more research. My chemist has a degree in alternative meds.

Do what you are doing and read, ask about - nothing is without risks. Apixiban is not offered in NZ yet.

cheers JOY 73. (NZ)

[Countrydweller2 in reply to JOY2THEWORLD49]

Bless! You have really had a rough time.

[JOY2THEWORLD49 in reply to Countrydweller2]

Hi

I'm just lucky to be still alive.

You will be too.

No drugs to early morning meds. Then I have to space them.

Gone are the days of bliss with no meds.

I'm alive to meet my great grand children, grand kids and my adopted from birth children who have now shown interest in me.

Its good to see 'growing' people.

With COVID it has been difficult to see grandchildren when in Auckland.

I am in the laid seaside town of Coopers Beach and have lived here 33 years

bar 6 years working in UK during 90s.

It's OK to ask Countrydweller. Disregard the megative you are asking and

that's the way to go.

But my Doug wouldn't eat grass to save him from his death of leukaemia so

folks are different. Prior he poured the worm dose down the sink when Mum, me lined the family up to give them all a dose.

By the way I had to stop PRADAXA 3 24-hr days before my TVT Kit removal in March I was fine but H/Rate under 100 or anaesthetic wouldn't operate.

And the thyroidectomy in Feb 2020 again stopped 3 days before, on the day and I waited 3 days post.

I get no nosebleds, dont have problems with stomach. But PRADAXA is better swallowed with juicem fruit as it dissolves better in acid.

You wil reach daylight and feel like one of us who have researched, asked and done some work before we have comfortably arrived at doing ManageMyHealth scenerio.

I never mind questions. It should go both ways to make this world in peace and unity.

I've bought reduced 1.5L A2 milk to try! Have you tried it?

Lunch brown rice, chicken, tomato, beetroot and wee salad leaves perhaps gherkins for lunch.

I get frustrated in my energy rate though. I guess it is the enlarge heart chamber.

Enjoy and take care countryite. I watch Sundays 'HELEN' camper on the road with .... Calman about UK exploring.

cheers JOY

[Gumbie_Cat]

I was put straight on Apixaban, and haven’t noticed any side effects. The anti arrhythmic drugs, and the beta-blockers, now that’s a different matter! (Dronedarone affected my liver enzymes, but within a month of stopping they were back to normal - while taking apixaban.) I have stopped drinking alcohol, though I didn’t drink much anyway, so it was no big deal for me to stop. Caffeine has been harder…

I do see the advantages of warfarin though, with the reassurance of INR checks.

I think this is because the rhythm drugs have failed for me, so I don’t know if the apixaban is working!